Nokea
A 55-year-old woman has been given a nonsteroidal anti-inflammatory drug (NSAID) for the treatment of rheumatoid arthritis. The nurse is reviewing the patient's medication history and notes that which types of medications could have an interaction with the NSAID? (Select all that apply.)
- A. Antibiotics
- B. Decongestants
- C. Anticoagulants
- D. Beta blockers
- E. Diuretics
- F. Corticosteroids
Correct Answer: C,E,F
Rationale: Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because of platelet inhibition and hypoprothrombinemia. NSAIDs taken with diuretics may cause reduced hypotensive and diuretic effects. NSAIDs taken with corticosteroids may cause increased ulcerogenic effects.
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A patient who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct?
- A. Aspirin is given to reduce anxiety.
- B. It helps to reduce inflammation.
- C. Aspirin is given to relieve pain.
- D. It will help to prevent clot formation.
Correct Answer: D
Rationale: Aspirin can reduce platelet aggregation; low doses of aspirin (81 to 325 mg once daily) are used for thromboprevention. Higher doses are required for pain relief, reduction of inflammation, and reduction of fever.
A patient with gout has been treated with allopurinol for 2 months. The nurse will monitor laboratory results for which therapeutic effect?
- A. Decreased uric acid levels
- B. Decreased prothrombin time
- C. Decreased white blood cell count
- D. Increased hemoglobin and hematocrit levels
Correct Answer: A
Rationale: Treatment of gout with allopurinol should result in decreased uric acid levels.
A patient calls the clinic to ask about taking a glucosamine-chondroitin supplement for arthritis. The nurse reviews the medication history and notes that there will be a concern for drug interactions if the patient is also taking medications for which disorder?
- A. Type 2 diabetes mellitus
- B. Hypothyroidism
- C. Hypertension
- D. Angina
Correct Answer: A
Rationale: Glucosamine may reduce the effectiveness of antidiabetic drugs by worsening insulin resistance, necessitating closer monitoring of blood glucose levels in patients with type 2 diabetes mellitus.
During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?
- A. Renal disease
- B. Diabetes mellitus
- C. Headaches
- D. Rheumatoid arthritis
Correct Answer: A
Rationale: Contraindications to NSAIDs include known drug allergy and conditions that place a patient at risk for bleeding, such as vitamin K deficiency, and peptic ulcer disease. Patients with documented aspirin allergy must not receive NSAIDs. Other common contraindications are those that apply to most drugs, including severe renal or hepatic disease.
The nurse is reviewing the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs), which include which effect?
- A. Anxiolytic
- B. Sedative
- C. Antipyretic
- D. Antimicrobial
Correct Answer: C
Rationale: NSAIDs have antipyretic effects but not the other effects listed.